Adenoids in Children

​​​​The adenoids are patches of tissue that sit at the very back of the nasal passage/top of the throat. Some parents may confuse the adenoids with the tonsils, which are visible at the back of the throat. However, the adenoids aren't directly visible in a routine nose or throat exam. Like tonsils, the adenoids do important work for babies and young children, as the adenoids are one of the first lines of defense when harmful bacteria and viruses are inhaled or swallowed.

As your child ages, the adenoids lose significance as the body learns how to fight infection. Adenoids begin to shrink in childhood. They continue to decrease in size into teen/adult years. Adenoids do not typically grow back, although that is not always the case.

​Symptoms of Enlarged Adenoids

Because they are on the front line of a body's defenses, it's possible that the adenoids may swell temporarily as they fight off infections. Multiple infections, allergies and other factors may cause chronic enlargement. When adenoids become enlarged, your child may experience:

• Difficulty breathing through the nose.
• Bad breath and dry lips from breathing through the mouth.
• Sounding as if the nose is pinched or stuffed.
• Frequent sinus symptoms.
• Snoring.
• Restless sleep or disruptive sleep apnea.
• Ongoing middle ear infections or fluid build-up in school age.

If your doctor suspects enlarged adenoids, he or she may perform a basic physical examination of the nose, throat, ears and feeling the neck along the jaw in order to diagnose. He or she may also use an x-ray or an endoscope, a long flexible tube with a light on one end.

Treatment of Enlarged Adenoids

If your child has minimal symptoms, no treatment is typically needed. Your doctor may recommend a nasal spray to help reduce swelling and potentially an antibiotic if the infection is bacterial. Another treatment for more severe cases is an adenoidectomy.

Adenoidectomy in Children

Adenoidectomy is the removal of the adenoids via surgery through the open mouth, with your child under general anesthesia for around 30 minutes. It is an outpatient procedure that may be done at the same time as a tonsillectomy. Your doctor may want to perform an adenoidectomy if your child:

• Has multiple episodes of adenoid infection and subsequent middle ear infections or fluid build-up in the ear.
• Shows no improvement of bacterial infection while taking an antibiotic.
• Suffers from nasal airway blockage.
• Develops obstructive sleep apnea.
• Has recurrent episodes of sinusitis.

Adenoidectomy recovery for your child may involve several days of mild to moderate pain and discomfort which usually responds to over-the-counter Tylenol or Ibuprofen. Your child may experience a runny nose and bad breath for a short time​. Keep your child well-hydrated with bland, non-carbonated drinks like apple juice and broth, and make sure he or she follows diet as instructed by your surgeon.​

• Transcript

  Tonsils and Adenoids - Boys Town Ear, Nose & Throat Institute

  Tonsils and adenoids are lymphatic tissue located in the back of the throat along the sides for the tonsils and directly behind the nose and the nasal pharynx. The most common that people are familiar with are viral infections and bacterial infections of the tonsils and the adenoids. But many times they are bothered by post nasal drainage from congestion, either viral or allergy involving the nose. It is much more common in children that we will see obstruction due to tonsil and adenoid enlargement. Parents will see snoring, nasal obstruction with mouth breathing, and certainly kids are more prone to recurrent tonsillitis and strep. Adults definitely do have problems. Theirs are more a chronic infection, low grade infection that just won’t go away with chronic soreness. Viral infections are going to be treated with support of care, lots of fluid, rest, and multivitamins. Bacterial infections such as strep which everyone is familiar with is going to be treated with antibiotics. If the inflammation of the tonsils is due to allergic drainage from the back of the nose, then generally antihistamines in a liquid or pill form and then nasal steroid sprays. Generally we will take tonsils out for two main reasons. If the tonsils are enlarged enough that they are causing obstructive symptoms that are significant, either difficulty swallowing meats and trouble gaining wait, they could be so enlarged that the child is snoring and not getting quality sleep and that can lead to behavior issues and difficulty learning in the classroom; and then recurrent strep infections or viral infections of the tonsils. If that’s happening too often and they are spending too many times on antibiotics, it can decrease their health and become enough of a problem that we need to remove them.​